Reader dilemma: 'My friend's anxiety is stopping her from doing anything'

"Obviously her first port of call should be her doctor. Tell her she’s insane not to try medication. Mindfulness would be another option."

(Rex)

Dear Virginia

One of my friends is extremely anxious. She says she rarely has a moment when she doesn’t suffer slightly, but increasingly she finds it hard to go out, and often rings up to put off dates because she has had a panic attack. She hasn’t been to see a film or get to the theatre for a year now, even though she used to love going out. I’ve tried to get her to see her doctor, but she’s very frightened of taking pills. All she’ll see is a hypnotist who seems to be taking her money but not improving matters. Is there any way I can help?

Yours sincerely, Henri

Virginia says

There’s no way you can help directly. But there are ways you can help indirectly – and one is to persuade your friend that there are myriad ways to lessen anxiety, and there’s no one cure-all remedy. Many people spend years trying out new cures and find that while one may work for a while, it often doesn’t cure the anxiety permanently. Time to go off on another quest.

I’d imagine that your friend continues with hypnosis because it had an initial beneficial effect. But anxiety is very good at putting up resistance to any solution. Once you’ve found a crack, it gets busy sealing up that crack, and you’ve got to find a new chink in its armour.

Obviously her first port of call should be her doctor. Tell her she’s insane not to try medication. She only has to give pills a whirl, and if they work, great, and if they don’t, she can move on.

She could also try some of the hundreds of herbal remedies. Again, the chances of them working are small, but at least she’ll have given them a try, and, who knows, she might be lucky.

Meditation – marketed now under its new name, mindfulness – would be another option. Give it a go for three months. It can’t do any harm.

And of course, exercise is one of the most recommended cures. Daily hard sessions in the gym can help burn up anxiety-making cortisone that’s whizzing round her body

She may well be helped by counselling, particularly CBT – cognitive behavioural therapy. CBT therapists can encourage her to look at her fears and face them – and find that nothing terrible happens when she does. Again, good results have been reached from this, though not necessarily long-lasting. Other counselling might be able to help her discover whether a trauma in her childhood has led to her anxiety – and again, this can be helpful. Knowledge is power, even if not the cure.

She should also look back into her past to see if any of her ancestors suffered. There’s a strong suspicion that anxiety may have genetic roots.

And finally – and here is one thing you can do to make a difference – buy her two books on anxiety. Despite their jokey titles, they’re brilliant. My Age of Anxiety: Fear, Hope, Dread, and the Search for Peace of Mind by Scott Stossel is one, and the other is Why Zebras Don’t Get Ulcers, by Robert M Sapolsky. Information-packed, humorous, enlightening and comforting, these books are not trivial. They do not offer cures – Stossel himself has learned, somehow, to live with the condition, albeit sometimes only with a curious blend of vodka shots and exact amounts of pills – but their understanding and depth of research can only be helpful.

Readers say...

Alternatives to medication

As someone who suffered badly from panic attacks from the age of 16 until about 45, and also resists taking pills, I suggest the following might help:

1) Encourage your friend to identify possible causes (maybe a trauma far back in the past). But accept there might not be one – it could be genetic.

2) Identify the triggers, such as social events. I guess she’s already done this, and the list has grown. A severe panic attack will make the sufferer do anything to avoid the situation that brought it on. Regrettably, attacks are often random.

3) Get some help on coping with an attack.

4) Point out that there are other aids besides pills, like counselling, yoga-type relaxation, and advice from books and the internet. Finding out what has helped other people, and knowing you’re not the only one, builds confidence.

5) Suggest she no longer sees the hypnotist.

6) Break ‘going out’ into little steps, where she always has the option to stop and go home. Just having this power will often prevent an attack.

Joy Watson

by email

Persevere with your support

Firstly, how lucky your friend is, Henri, to have someone like you to care about her and encourage her to try to tackle her anxiety without pushing her. Supportive people can be the key to tackling social situations when you’re anxious. I’ve had difficulties with panic attacks, anxiety and depression myself, and one of the things that kept me going was still being invited to things, even if I had to bail on the day. So please don’t give up on her. One day she might well be able to make it and that could be the stepping stone she needs to help get back to being in control of her anxiety.

I also refused medication. I tried counselling but it didn’t work for me, but CBT was a godsend – it gave me tools to use whenever I feel I am getting too anxious or might panic. It’s available on the NHS, as it’s been scientifically proven to work well. Perhaps that would persuade your friend to ask her GP for help? If she is able to see that nobody will force her to take medication if she doesn’t want to, she takes back a tiny bit of control over her life, and hopefully can then access some help that will have a lasting effect. If her current GP is unhelpful, she should see a different GP.

Lisa Jones

by email

Next week's dilemma

Dear Virginia, My daughter has been going out with the same man for six years. I feel he’s sponging off her because he hardly contributes to the expenses of her flat and does very little work. But because he’s amusing and good looking he gets away with it. She keeps hoping that he’ll ask her to marry him and she wants children, but he keeps saying he’s not ready – he’s 30 and she’s 34. I fear he’s one of nature’s “boys” and it’s only a matter of time until he finds someone to mother to him and he’ll leave my daughter high and dry. Should I interfere?

Yours sincerely,

Martha

What would you advise Martha to do? To answer this dilemma, or to share your own problem, write to dilemmas@independent.co.uk

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